Provider Demographics
NPI:1912767294
Name:LOTT, KARLEE NICOLE (CBT, CAPM, CSM)
Entity Type:Individual
Prefix:MRS
First Name:KARLEE
Middle Name:NICOLE
Last Name:LOTT
Suffix:
Gender:F
Credentials:CBT, CAPM, CSM
Other - Prefix:MS
Other - First Name:KARLEE
Other - Middle Name:NICOLE
Other - Last Name:STUBBEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:950 BROADWAY STE 303
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-4454
Mailing Address - Country:US
Mailing Address - Phone:253-671-9909
Mailing Address - Fax:
Practice Address - Street 1:950 BROADWAY STE 303
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-4454
Practice Address - Country:US
Practice Address - Phone:253-671-9909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician